“开窗”技术在主动脉弓部病变中的临床应用

"Fenestrated"technology thoracic endovascular aortic repair for aortic arch lesions

临床上针对主动脉弓部病变治疗尚未形成统一标准,主要由于主动脉弓部病变解剖复杂、弓上存在重要分支血管。“开窗”技术的出现可解决近段锚定区不足、弓上分支血管重建等问题,也扩大了胸主动脉腔内修复术治疗主动脉弓部病变的适应证,但需考虑其支架移植物耐久性、超适应证、颅脑灌注及远期疗效不确定性等问题。本文主要回顾了“开窗”技术在主动脉弓部病变中的应用进展,为其临床应用进行简要说明。

Standard treatment for aortic arch lesions hasn't been established clinically.The main reason is that the aortic arch lesions are anatomically complex and have multiple important branch vessels on the arch.The emergence of fenestrated technology can solve the problems of insufficient proximal anchoring area and revascularization of the branches of the aortic arch,and greatly expand the indications of thoracic aortic endovascular repair in the treatment of aortic arch lesions.However,it is necessary to consider the durability of the stent graft,off-label indication,craniocerebral perfusion,and uncertainty of long-term efficacy.This article mainly reviews the progress of the fenestrated technology in aortic arch lesions,and briefly explains its clinical application.